Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00079 | Date 03/08/2018 |
| Token No | SM/19-20/5337 26/06/2019 | Serial | 001 Last Visit: 08/12/2025 |
| Patient Name | Mrs. RADHA DAS | Contact No | 8584949008 |
| Address | 52, CHATRA LANKAR BAGAN | Age | 75 Years,11 Months,6 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||